Delayed cerebrospinal fluid leakage 10 years after transsphenoidal surgery and gamma knife surgery - Case report

Yoshikazu Ogawa, Teiji Tominaga

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

A 38-year-old woman presented with repeated episodes of meningitis. She had undergone transsphenoidal tumor removal followed by gamma knife irradiation in 1994. Complete remission was achieved. Intermittent cerebrospinal fluid (CSF) leakage began in 2004, and transsphenoidal surgery was performed for direct repair of the skull base defect. Operative findings showed that the sellar floor was uncovered, and CSF continuously escaped through the cyanoacrylate polymer framework of the previous repair. Reconstruction used autologous muscle pieces and cyanoacrylate polymer adhesive. The CSF leakage was presumably due to delayed radiation damage to the mucous membrane of the skull base. Several methods for reconstruction of the sellar floor have been proposed, which all rely on tissue regeneration including the arachnoid, dura mater, and mucus membrane of the sphenoidal sinus. Preservation of the arachnoid membrane and minimizing removal of the mucous membrane are essential, especially if postoperative irradiation is anticipated.

Original languageEnglish
Pages (from-to)483-485
Number of pages3
JournalNeurologia medico-chirurgica
Volume47
Issue number10
DOIs
Publication statusPublished - 2007

Keywords

  • Cerebrospinal fluid leakage
  • Radiosurgery
  • Transsphenoidal surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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